Advances in the study of mitophagy in osteoarthritis. / çº¿ç²’ä½“è‡ªå™¬è°ƒæŽ§éª¨å ³èŠ‚ç‚Žçš„æœ€æ–°è¿›å±•.

Osteoarthritis (OA), characterized by cartilage degeneration, synovial inflammation, and subchondral bone remodeling, is among the most common musculoskeletal disorders globally in people over 60 years of age. The initiation and progression of OA involves the abnormal metabolism of chondrocytes as an important pathogenic process. Cartilage degeneration features mitochondrial dysfunction as one of the important causative factors of abnormal chondrocyte metabolism. Therefore, maintaining mitochondrial homeostasis is an important strategy to mitigate OA. Mitophagy is a vital process for autophagosomes to target, engulf, and remove damaged and dysfunctional mitochondria, thereby maintaining mitochondrial homeostasis. Cumulative studies have revealed a strong association between mitophagy and OA, suggesting that the regulation of mitophagy may be a novel therapeutic direction for OA. By reviewing the literature on mitophagy and OA published in recent years, this paper elaborates the potential mechanism of mitophagy regulating OA, thus providing a theoretical basis for studies related to mitophagy to develop new treatment options for OA.

Advances in the study of protein folding and endoplasmic reticulum-associated degradation in mammal cells. / å“ºä¹³åŠ¨ç‰©ç»†èƒžè›‹ç™½è´¨æŠ˜å å’Œå† è´¨ç½‘ç›¸å ³é™è§£çš„ç ”ç©¶è¿›å±•.

The endoplasmic reticulum is a key site for protein production and quality control. More than one-third of proteins are synthesized and folded into the correct three-dimensional conformation in the endoplasmic reticulum. However, during protein folding, unfolded and/or misfolded proteins are prone to occur, which may lead to endoplasmic reticulum stress. Organisms can monitor the quality of the proteins produced by endoplasmic reticulum quality control (ERQC) and endoplasmic reticulum-associated degradation (ERAD), which maintain endoplasmic reticulum protein homeostasis by degrading abnormally folded proteins. The underlying mechanisms of protein folding and ERAD in mammals have not yet been fully explored. Therefore, this paper reviews the process and function of protein folding and ERAD in mammalian cells, in order to help clinicians better understand the mechanism of ERAD and to provide a scientific reference for the treatment of diseases caused by abnormal ERAD.

Exercise regulates bone metabolism via microRNAs / 生理学报

It has been well documented that exercise can improve bone metabolism, promote bone growth and development, and alleviate bone loss. MicroRNAs (miRNAs) are widely involved in the proliferation and differentiation of bone marrow mesenchymal stem cells, osteoblasts, osteoclasts and other bone tissue cells, and regulation of balance between bone formation and bone resorption by targeting osteogenic factors or bone resorption factors. Thus miRNAs play an important role in the regulation of bone metabolism. Recently, regulation of miRNAs are shown to be one of the ways by which exercise or mechanical stress promotes the positive balance of bone metabolism. Exercise induces changes of miRNAs expression in bone tissue and regulates the expression of related osteogenic factors or bone resorption factors, to further strengthen the osteogenic effect of exercise. This review summarizes relevant studies on the mechanism whereby exercise regulates bone metabolism via miRNAs, providing a theoretical basis for osteoporosis prevention and treatment with exercise.

Risk factors for residual pain after percutaneous kyphoplasty for osteoporotic vertebral fractures / 中华创伤骨科杂志

Objective:To analyze the risk factors for residual pain after percutaneous kyphoplasty (PKP) for osteoporotic vertebral fractures (OVF).Methods:Retrospectively analyzed were the patients with OVC who had been treated at Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University by single level PKP from January 2020 to December 2021. They were 40 men and 181 women, with an age of (69.6±8.2) years. By the pain score of visual analogue scale (VAS) on the postoperative day 3, they were assigned into 2 groups: a residual pain group (VAS≥4) and a control group (VAS<4). The general demographics, radiographic and surgical related data of the 2 groups were analyzed by single factor analysis, including their gender, age, bone mineral density, body mass index, glucocorticoid usage, follow-up time, duration of symptoms, fracture location, severity of fracture compression, intravertebral cleft, middle column involvement, thoracolumbar fascia injury, anesthesia method, puncture method, volume of bone cement injected, cement-endplates contact, pattern of cement distribution, cement leakage, vertebral height restoration, preoperative cobb angle and correction of cobb angle. The P<0.1 factors screened were further analyzed by the multivariate logistic regression to determine the final variables. Results:In the present study, 19 patients were assigned into the residual pain group and 202 patients the control group. The univariate analysis showed that body mass index ( P=0.059), intravertebral cleft ( P=0.049) and thoracolumbar fascia injury ( P< 0.001) increased the risk for residual pain. The multivariate logistic regression analysis showed that thora-columbar fascia injury was an independent risk factor for residual pain ( OR=6.127, 95% CI: 2.240 to 16.755, P<0.001). Conclusion:Thoracolumbar fascia injury is an independent risk factor for residual pain after PKP for OVF.

Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair (version 2023) / 中华创伤杂志

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.

Advances of mitophagy involved in diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Mitochondrial function is essential for the viability of aerobic eukaryotic cells, as mitochondria provide energy through the generation of adenosine triphosphate(ATP), regulate cellular metabolism, provide redox balancing, participate in immune signaling, and initiate apoptosis. Mitophagy refers to the selective elimination of dysfunctional mitochondria in cells, thereby achieving mitochondrial quality control and maintaining cell homeostasis. Recent studies have indicated that abnormal mitophagy is involved in the development of various eye diseases, such as diabetic retinopathy(DR), age-related macular degeneration and glaucoma. In this review, we summarize the current knowledge on the definition of mitophagy, and present the results of various studies using cell culture, animal, and human tissue models. Additionally, we review the molecular process of mitophagy and its role in DR, thus providing novel ideas for the treatment of DR.

Nimbolide targeting SIRT1 mitigates intervertebral disc degeneration by reprogramming cholesterol metabolism and inhibiting inflammatory signaling

Inflammation, abnormal cholesterol metabolism, and macrophage infiltration are involved in the destruction of the extracellular matrix of the nucleus pulposus (NP), culminating in intervertebral disc degeneration (IDD). Whether nimbolide (Nim), a natural extract, can alleviate IDD is unclear. In this study, we demonstrated that Nim promotes cholesterol efflux and inhibits the activation of the nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways by activating sirtuin 1 (SIRT1) in nucleus pulposus cells (NPCs) during inflammation. Thus, Nim balanced matrix anabolism and catabolism of NPCs. However, the inhibition of SIRT1 significantly attenuated the effects of Nim. We also found that Nim promoted the expression of SIRT1 in RAW 264.7, which enhanced the proportion of M2 macrophages by facilitating cholesterol homeostasis reprogramming and impeded M1-like macrophages polarization by blocking the activation of inflammatory signaling. Based on these results, Nim can improve the microenvironment and facilitate matrix metabolism equilibrium in NPCs. Furthermore, in vivo treatment with Nim delayed IDD progression by boosting SIRT1 expression, modulating macrophage polarization and preserving the extracellular matrix. In conclusion, Nim may represent a novel therapeutic strategy for treating IDD.

Research progress on traditional Chinese medicine compounds combined with external therapy in treatment of hyperplasia of mammary glands / 中国中药杂志

Hyperplasia of mammary glands is a benign breast disease with disordered breast structure. Nowadays, the incidence rate of breast hyperplasia in women is increasing year by year, and the etiology is related to the imbalance of estrogen and progesterone in the body. The symptoms include breast pain, breast nodules, or nipple discharge, which can develop into breast cancer in the context of psychological pressure. Therefore, it is timely and effectively necessary for people to treat the symptoms. At present, traditional Chinese medicine(TCM) often treats breast hyperplasia by oral drug, external application, acupuncture, moxibustion, and massage, while western medicine often uses hormone therapy or surgery. TCM can regulate hormone levels to treat breast hyperplasia. Acupuncture, moxibustion, and other methods can stimulate acupoints to reduce breast lumps. However, since TCM is easy to produce hepatorenal toxicity after long-term use and simple external treatment is slow to take effect, rapid and effective treatment is difficult to be achieved. Although western medicine can inhibit the disease, it is easy to produce toxic and side effects if taken for a long time. In addition, surgery can only remove the focus and the recurrence rate is high. Some studies have found that the combination of oral and external use of TCM compounds has a significant effect, with mild toxic and side effects, few adverse reactions, and a low recurrence rate. Based on the relevant literature in recent years, this article reviewed the combination of oral and external treatment of TCM in the treatment of hyperplasia of mammary glands, discussed the effectiveness, clinical evaluation indexes, and mechanism, and pointed out the existing shortcomings to explore a comprehensive therapy worthy of clinical application.

Cross-sectional study of zero-medicine markup policy, prescribing trends and drug indicators using WHO/INRUD methodology in Chinese Jingzhou area.

In order to get the baseline data of Chinese Zero-Medicine Markup Policy, before any administrative intervention we investigated the drug indicators, the prescribing trends and economic data. In accordance with the WHO/INRUD criteria and cross-sectional studies, the retrospective methods along with equal sample interval of systematic sampling were used. We sampled from daily prescriptions and calculated the means over a twelve day period. We sampled from 38,246 adult prescriptions, the sampling percent was 3.06% and the drugs prescribed by generic name were 100.00%. During 2012-2014, the percentage of antibiotic cost in the total daily drug cost decreased from 17.44% to 8.01%, the percentage of prescriptions with antibiotic prescribed decreased from 12.64% to 9.64%, the percentage of encounters with an injection prescribed decreased from 15.21% to 12.77%. The average drug cost per antibiotic prescription ranged from ¥169.33 to 186.66. By comparing the related data, Zero-Medicine Markup Policy had greatly affected prescribing indicators, some indicators had a decreasing trend and became more rational, Zero-Markup Medicine Policy decreased both the patient-level and hospital-level drug expenses, and the reformation of the Zero-Medicine Markup Policy was steadily advanced.

Association between gender role and family factors among primary school students in Xiamen / 中国学校卫生

Objective@#To analyze the association between masculine and feminine traits, gender role in students and family factors, and to provide a scientific basis for promoting the healthy development of children and adolescents gender role.@*Methods@#Cluster random sampling method was used to selected 823 students from 2 schools of Xiamen in May, 2018, participants were asked to report individual masculine and feminine traits through the Child s Sex Role Inventory, and then gender role was divided into four types (masculine, feminine, androgynous, undifferentiated). Non parametric tests, generalized linear model, and Logistic regression model were used to explore the association between masculine and feminine traits, gender role and family factors.@*Results@#Compared with the boys from the nuclear family, the masculine traits were lower in boys of other families by 0.282( 95% CI = -0.452 --0.110), and the feminine traits were also lower by 0.192 (95% CI =-0.369--0.014). Compared with boys of middle socioeconomic status (SES), the masculine traits of boys from low SES decreased by 0.157 (95% CI =-0.286--0.029), and the feminine traits decreased by 0.140 (95% CI =-0.274--0.005). The proportion of androgynous in boys from other families was significantly lower than boys from the nuclear family ( OR =0.45, 95% CI =0.21-0.94), with the proportion of undifferentiated significantly higher than nuclear family 2.33 (95% CI =1.22-4.44). The proportion of androgynous in boys from low SES was significantly lower than boys from middle SES ( OR =0.59, 95% CI =0.35-0.99), with the proportion of undifferentiated significantly higher than middle SES 1.62 (95% CI =1.00-2.65). Among girls, the differences in masculine and feminine traits and gender role of different family factors were not statistically significant ( P >0.05).@*Conclusion@#The masculine and feminine traits and gender role in students are associated with family structures and socioeconomic status, especially in boys. Therefore, the family environment is an important factor affecting children s gender role, and the healthy development of children s gender role needs parents attention and correct guidance.

Analysis of clinical, pathological features and prognosis of microscopic polyangiitis / 中国医师进修杂志

Objectives:To analyze the clinical features of microscopic polyangiitis (MPA), and observe the clinical outcomes of different pathological types.Methods:The clinical data of 61 patients with MPA in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2019 were analyzed retrospectively. According to age, the patients were divided into ≥ 60 years old group (46 cases) and<60 years old group (15 cases). According to the initial serum creatinine, the patients were divided into ≥ 500 μmol/L group (18 cases) and<500 μmol/L group (43 cases). The basic data and laboratory examination results of the patients were recorded, and the disease activity was evaluated by Birmingham systemic vasculitis activity score (BVAS). Twenty-three patients with complete pathological data were pathologically classified and followed up to assess their clinical outcomes. The progression to end-stage renal disease (ESRD) or death was defined as the endpoint.Results:Ferritin in ≥60 years old group was significantly higher than that in<60 years old group: 452 (289, 792) μg/L vs. 210 (119, 451) μg/L, and there was statistical difference ( P<0.05). The fever rate, hemoglobin and platelets in creatinine ≥ 500 μmol/L group were significantly lower than those in creatinine<500 μmol/L group: 3/18 vs. 48.8% (21/43), 77.5 (62.8, 86.0) g/L vs. 85.0 (77.0, 104.0) g/L and 192 (147, 234) × 10 9/L vs. 257 (208, 365) × 10 9/L, the gastrointestinal involvement and BVAS in creatinine ≥ 500 μmol/L group were significantly higher than those in creatinine<500 μmol/L group: 16/18 vs. 25.6% (11/43) and 20.0 (16.0, 23.3) scores vs. 15.0 (12.0, 19.0) scores, and there were statistical differences ( P<0.05 or<0.01). Pearson correlation analysis result showed that BVAS was positively correlated with creatinine ( r = 0.42, P<0.01), negatively correlated with hemoglobin ( r = -0.42, P<0.01), but it had no correlation with erythrocyte sedimentation rate and platelets ( r = 0.05 and 0.04, P>0.05). Among the 23 patients with completed the clinical outcome statistics, endpoint events occurred in 5 of 6 patients with crescent renal pathology, and in 7 of 12 patients with severe renal interstitial injury. Kaplan-Meier survival curve analysis result showed that the average survival time in ESRD MPA patients was significantly shorter than that in non ESRD MPA patients (41.2 months vs. 63.5 months), and there was statistical difference ( χ2 = 0.48, P = 0.028). Conclusions:The clinical manifestations of elderly MPA patients are similar to those of young MPA patients. Creatinine≥500 μmol/L or anemia at initial onset indicate higher vasculitis activity in MPA. The prognosis of MPA patients with pathological manifestations of crescent or severe interstitial injury is poor, and the survival rate of ESRD is lower than that of non ESRD patients.

Co-regulation of circadian clock genes and microRNAs in bone metabolism / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Mammalian bone is constantly metabolized from the embryonic stage, and the maintenance of bone health depends on the dynamic balance between bone resorption and bone formation, mediated by osteoclasts and osteoblasts. It is widely recognized that circadian clock genes can regulate bone metabolism. In recent years, the regulation of bone metabolism by non-coding RNAs has become a hotspot of research. MicroRNAs can participate in bone catabolism and anabolism by targeting key factors related to bone metabolism, including circadian clock genes. However, research in this field has been conducted only in recent years and the mechanisms involved are not yet well established. Recent studies have focused on how to target circadian clock genes to treat some diseases, such as autoimmune diseases, but few have focused on the co-regulation of circadian clock genes and microRNAs in bone metabolic diseases. Therefore, in this paper we review the progress of research on the co-regulation of bone metabolism by circadian clock genes and microRNAs, aiming to provide new ideas for the prevention and treatment of bone metabolic diseases such as osteoporosis.

Correlations between content of linarin in Chrysanthemum indicum and climatic factors in habitats / 中国中药杂志

Chrysanthemi Indici Flos(CIF), the capitulum of Chrysanthemum indicum, is widely used in proprietary Chinese medicine and daily chemical products. At present, CIF is mainly produced from wild resources and rarely cultivated. This study aims to reveal the correlations between linarin content in CIF and climatic factors in different habitats, and provide a theoretical basis for suitable zoning and rational production of medicinal materials. The content of linarin in CIF was determined by HPLC. Grey relational analysis and Pearson correlation analysis were carried out for linarin content with climatic factors. The results showed that the content of linarin in CIF was significantly different among different habitats. The grey relational degrees of climatic factors with linarin content was in an order of average annual precipitation>annual average sunshine hours>annual average temperature>longitude>annual frost-free period>latitude>altitude. Longitude, annual average temperature and average annual precipitation had significantly positive correlations with the content of linarin in CIF, whereas latitude and altitude showed negative correlations with it. The annual frost-free period and annual average sunshine hours had no significant correlation with the content of linarin in CIF. The content of linarin in CIF varied significantly in different habitats. High longitude, low latitude, low altitude, high annual average temperature and high annual average precipitation could be used as indicators for the habitats of high-quality Ch. indicum. This study provides a reference for selecting suitable producing areas of Ch. indicum and establishing artificial cultivation system.

Comprehensive antioxidant and anti-inflammatory activity of alcohol extracts from Chrysanthemum indicum in different areas based on entropy weight and TOPSIS methodology / 中国中药杂志

The study is aiming at investigating the application of entropy weight TOPSIS method in the comparison of the scavenging effect of DPPH, ABTS and hydroxyl radical and the inhibition effect of xanthine oxidase(XOD) and lipoxygenase(LOX) of Chrysanthemum indicum. The DPPH, ABTS, salicylic acid and spectrophotometry were used to determine the scavenging effect of DPPH, ABTS and hydroxyl radical and the inhibition effect of xanthine oxidase(XOD) and lipoxygenase(LOX) of Ch. indicum from 31 different areas in vitro. Take the half inhibition rate of as the evaluation index, two principal components were extracted by the principal component analysis, and their cumulative contribution rate reached at 92.4%. The different areas of Ch. indicum could be divided into Dabei Mountain and Qinling-Taihang Mountain by use principal component to analysis. The entropy weight TOPSIS method was used to objectively assign weights to five indexes, calculate the weight of each index and set up the best and worst scheme of the evaluation object, and the relative proximity(C_i) was used as the measure to construct the multi-index comprehensive evaluation model of Ch. indicum. And then sort with the relative proximity value. The results showed that the relative proximity was between 0.098 and 0.983 which represents there were significant differences in the scavenging effect of DPPH, ABTS and hydroxyl radical and the inhibition effect of xanthine oxidase(XOD) and lipoxygenase(LOX) between extracts of Ch. indicum from different areas. The Ch. indicum from Dabie Mountain area have a relatively high relative degree of measurement and high-quality ranking. Taken together, the quality of Ch. indicum.from the Dabie Mountain area is better. The index weight coefficient and the classification result of producing area are basically consistent with the result of principal component analysis. The results show that the TOPSIS method based on entropy weight method can be used to evaluate the comprehensive quality of Ch. indicum.

Efficacy and safety of dual versus mono antiplatelet therapy in patients with stroke or transient ischemic attack: An updated meta-analysis of 18 randomized controlled trials.

The optimal duration of dual antiplatelet therapy (DAPT) as a routine treatment in stroke patients is still controversial. The efficacy and safety of DAPT may vary with different regiments, initiating treatment time and race. Our study assessed the efficacy and safety of DAPT in patients with stroke and to determine the factors influencing the efficacy and safety of DAPT. Relevant studies published up to May 2019 from PubMed, Embase, Web of Science and the Cochrane Library. Randomized controlled trials comparing DAPT with mono antiplatelet therapy (MAPT) for stroke secondary prevention were included. The primary endpoints were stroke recurrence, ischemic stroke recurrence and all-cause death. Subgroup analysis was made according to regiment, initiating treatment time and race. Eighteen studies (n=33353) were included. Comparing with MAPT, short-term DAPT reduced stroke recurrence (RR = 0.68, 95% CI = 0.60-0.77) and ischemic stroke recurrence (RR = 0.67, 95% CI = 0.59-0.77) but increased major bleeding (RR = 1.82, 95% CI = 1.11-2.98). Long-term DAPT had no superiority compared with MAPT. Aspirin plus clopidogrel comparing with aspirin and early initiating treatment time comparing with MAPT decreased stroke recurrence (RR = 0.74, 95% CI = 0.67-0.83; RR = 0.69, 95% CI = 0.61-0.78) and ischemic stroke recurrence ( RR = 0.71, 95% CI = 0.64-0.79; RR = 0.68, 95% CI = 0.59-0.77) but also increased major bleeding (RR = 1.70, 95% CI = 1.38-2.09; RR = 1.75, 95% CI = 1.07-2.85). DAPT reduced stroke and ischemic stroke recurrence in non-Asian group but only reduced ischemic stroke recurrence in Asian group. As stroke secondary prevention, short-term DAPT rather than long-term DAPT could be a better choice. Patients could benefit more from aspirin plus clopidogrel or given DAPT within 72 h after symptoms onset. Race may be a factor influencing the efficacy of DAPT.

Antibodies to SARS/CoV-2 in arbitrarily-selected Atlanta residents

We quantitated anti-SARS/CoV-2 IgG and IgM by ELISA in self-collected blood samples (n=142) in arbitrarily-selected metro Atlanta residents, primarily acquaintances of the authors lab members from 4/17-4/27, 2020. Archived serum (n=34), serum from nucleic acid test (NAT)-positive subjects (n=4), and samples collected from NAT-positive community members (n=4) served to validate the assay. The range of anti-SARS/CoV-2 antibodies in archived and NAT-positive sera indicated need to compromise sensitivity or specificity. Accordingly, we set a cutoff of 4 SD above the mean for IgG and 3 SD above the mean for IgM to indicate that an individual had been exposed, and developed some degree of immunity, to SARS/CoV-2. The IgG cutoff clearly compromised sensitivity but offered high specificity, both of which were harder to gauge for IgM. Based on these cutoffs, excluding subjects whose participation resulted from self-suspected SARS/CoV-2 infection, we found 7.1% positivity for anti-SARS/CoV-2 IgG (3 of 127 subjects) or IgM (6 of 127). While we do not claim this small immune survey is broadly representative of metro Atlanta, and we have greater confidence in the IgG results, which had only 2.4% positivity, it nonetheless demonstrates that persons with antibodies to SARS/CoV-2, whove not suspected theyd been exposed to this virus, can readily be found in various Atlanta area neighborhoods (9 positives were in 8 zip codes). Accordingly, these results support the notion that dissemination of the virus is more widespread than testing would indicate but also suggests that most persons in metro Atlanta remain vulnerable to this virus. More generally, these results support the general utility of sero-surveillance to guide public policy but also highlight the difficulty of discerning if individuals have immunity to SARS/CoV-2.

Effect of antiplatelet pretreatment on platelet aggregation and clinical outcomes in acute ischemic stroke patients treated with recombinant tissue-type plasminogen activator.

Early administration of antiplatelet agents in acute ischemic stroke patients (AIS) receiving intravenous thrombolysis (IVT) is a potential therapeutic strategy, however, safety and efficacy are not well established. We hypothesize that antiplatelet pretreatment (AP) before IVT have a similarly role as initiation of AP within the first 24 hours following IVT. We aimed to explore the effect of AP on platelet aggregation and clinical outcomes in thrombolysis-treated AIS patients. We enrolled AIS patients treated with IVT at the Neurology Department of the Nanjing First Hospital from January 2016 to June 2018. Prior use of antiplatelet agent was recorded. Light transmittance aggregometry was used to estimate the maximum platelet aggregation (MPA). Linear regression model was performed to investigate the factors associated with MPA. Multivariate logistic regression was used to analyse the association between AP and clinical outcomes. A total of 59 patients were included; 23 (38.9 %) were taking antiplatelet agent before stroke. Prior AP (ß = -20.209, SE mean=6.574; P=0.004) was significantly lower the arachidonic acid-induced MPA at the time point of 3h after thrombolysis. AP did not increase of the risk for sICH (OR=3.41, 95%CI 0.16-7.20, p=0.436) or mortality (OR=3.55, 95%CI 0.39-8.52, p=0.260). There were no associations between AP and improved clinical outcomes (all P>0.05). In thrombolysis-treated AIS patients, AP was associated with lower MPA after thrombolysis. AP is safe in these patients, however, further studies are required to confirm the efficacy.

Research Progress on Mechanical Characteristics of Articular Cartilage / 医用生物力学

Osteoarthritis (OA) is a chronic degenerative joint disease characterized by joint pain and stiffness, which predisposes to the elderly. The onset of OA is slow, the course of disease is long, and the early clinical manifestations and histological changes are not obvious, which limits the early diagnosis and treatment of the disease. The micro-structure of articular cartilage determines the macro-mechanical properties of cartilage. The micro-structure of articular cartilage changes in a depth-dependent manner, which makes the mechanical properties of cartilage also depth-dependent. From superficial to deep areas of cartilage, the anti-load and anti-deformation ability of cartilage increases gradually. However, with development of the disease, the change of cartilage micro-structure leads to the decrease in load resistance and deformation resistance of OA cartilage. Therefore, the mechanical properties of articular cartilage can be inferred by detecting the micro-structure of articular cartilage. On the other hand, the mechanical properties of articular cartilage can be used to understand the micro-changes of cartilage, which is helpful to understand OA development and facilitate early diagnosis of the disease. This paper reviewed the recent research literatures on mechanical properties of articular cartilage under normal and acute or chronic injuries, and elaborated the relationship between the structure and mechanical properties of articular cartilage, which further provided the theoretical basis for the OA development, early diagnosis and treatment.

Advice on Standardized Diagnosis and Treatment for Spinal Diseases during the Coronavirus Disease 2019 Pandemic

Coronavirus disease 2019 (COVID-19) outbreak started in December 2019 that caused difficulties for clinical work. Practical work experience in our spinal outpatient and emergency department during the COVID-19 pandemic is summarized in this article, with combined evidence-based medical evidence to explore a standardized process of diagnosis and treatment for spinal diseases. Outpatient reservation, continuous screening, triage, and isolation, first consultation accountability system, pandemic reporting system, and online revisit were strictly followed. We hope that our experience in prevention and control of COVID-19 can help spine surgeons globally in stopping the spread of COVID-19. Spine surgeons should collaborate with infection control specialists to avoid cross-infection in hospitals and optimize treatment.

Consecutive nightly measurements are needed for accurate evaluation of nocturnal erectile capacity when the first-night laboratory recording is abnormal / 亚洲男科学杂志(英文版)

Multiple measurements of nocturnal penile tumescence and rigidity (NPTR) are widely accepted as a method to differentiate psychogenic erectile dysfunction (ED) from organic ED. However, direct evidence remains limited regarding the first-night effect on NPTR measurement using the RigiScan. Here, we evaluated the first-night effect on the results of NPTR measurement to validate the necessity of NPTR measurement for two consecutive nights, particularly when abnormal first-night measurements are recorded in a laboratory setting. We retrospectively reviewed 105 patients with a complaint of ED, who underwent NPTR measurement using the RigiScan in the Department of Infertility and Sexual Medicine, the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China), for two consecutive nights, during the period from November 2015 to May 2016. NPTR parameters were collected and analyzed. We found that more effective nocturnal erections were detected during the second night than during the first night (P <0.001). Twenty percent of all patients had no effective erection during the first night, but exhibited at least one effective erection during the second night. The negative predictive value of NPTR measurement during the first night was 43.2%; this was significantly lower than that on the second night (84.2%; P = 0.003). Most NPTR parameters were better on the second night than on the first night. The first-night effect might be greater among patients younger than 40 years of age. In conclusion, two consecutive nightly measurements of NPTR can avoid a false-abnormal result caused by the first-night effect; moreover, these measurements more accurately reflect erectile capacity, especially when the first-night record is abnormal in a laboratory setting.